Peer Reviewer Application and Qualification Form

United States Department of Agriculture (USDA) | Grant Review Information

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United States Department of Agriculture
(USDA)
Peer Reviewer Application and Qualification Form
Complete the information below to indicate your qualifications to review proposals for USDA-AMS
Grants Division. The form must include a copy of your résumé with all employment and volunteer
locations.
Additional information on how to become a reviewer can be found on the specific program webpages:
http://new.grantreviewinfo.net/content/united-states-department-agriculture-usda-federal
(http://www.ams.usda.gov/services/grants/peer-review)
For further consideration, please provide all requested information below. Please note that resumes
should be no more than five-pages.

Please select what Program(s) that you would like to be considered as a reviewer:
Specialty Crop Multi-State Program (SCMP)

Contact Information
Last Name *

First Name *

Email *

Phone *

Fax

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United States Department of Agriculture (USDA) | Grant Review Information

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Street Address *

City

State *

Zip Code

Academic Background
Highest Degree in Education
- None -



Degree Area

Other (please specify):

Profession/Rank
- None -



Employer
Employer Name

Department

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United States Department of Agriculture (USDA) | Grant Review Information

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Employer Type

Select All that Apply
Federal
State
Tribal Government
Local Government
1890 Land Grant University
Private College/University
Small/Mid-sized Institution
State Agriculture Dept
Private Sector
Farmer/Producer/Rancher
CSA
Retired/Volunteer
1994 Land Grant University
Private Research
Hispanic Serving Institution
Nonprofit
Public Benefit Corp
Economic Develop. Corp
1862 Land Grant University
Public Non-Land-Grant University
USDA EPSCoR
Other Minority Serving Institution
Agricultural Market
Value-Added Products
Regional Planning
Other Minority Serving Institution
Other
Other (please specify):

Previous Federal Grant Application Review Experience

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United States Department of Agriculture (USDA) | Grant Review Information

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Conflict(s) of Interest
For further consideration it is imperative that all potential reviewers complete the Conflict of
Interest Form prior to accessing the applications. Click on the Conflict of Interest Form hyperlink to
review the information. Print, sign, date, and save it on your computer. Then upload the form to
this website.
Download Conflict of Interest Form (/sites/default/files/program_main_files/Conflict-Of-Interest%
20%26%20Confidentiality%20Statement%202018%20FILLABLE.pdf)
Upload Conflict of Interest Form
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Upload

Please rename file by adding Last Name and Year before uploading.
More information
Comment(s)

Expertise
Select as many as appropriate
Grant Writing
Women, Infants and Children (WIC)
Aggregator
Financial/Budget
Senior Farmers’ Market Nutrition Program (SFMNP)
Distribution
Nutrition
Electronic Benefits Transfer (EBT)
Direct Marketing
Architecture/Engineering
CSA Operation

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United States Department of Agriculture (USDA) | Grant Review Information

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Agri-Tourism
Farmers Market
Supplemental Nutrition Assistance Program (SNAP)
Processing
Farmers Market Management
Agricultural Cooperative
Food Banks
Educator/Academia
Roadside Stand Operation
Environmental Management
Technical Assistance Marketing
Technical Assistance Business Planning
Agricultural Production
Ag/Resource Economics
Consumer Economics/WTP
Extension Office
Food/Ag Marketing
Food Safety
Foreign Market Devel/Exports
Labeling/Branding
Local/Regional Food Systems
New Uses for Ag Products
Post-Harvest Handling
Price Discovery
Product Devel/Testing
Producer Training/Tech Assistance
Rural Economic Devel
Transportation/ Logistics/Distribution
Quality/Standards
Aquaculture
Bioenergy
Dairy
Forest/Wood Products
Grain/OilSeeds
Horticulture/Nursery
Livestock, Meat, Poultry

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United States Department of Agriculture (USDA) | Grant Review Information

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Specialty Crops
Food Waste
Other

Please upload your resume and do not exceed the five-page limit. Please provide your
resume in one of the following formats: MS Word (doc, docx), Adobe (pdf). Files must be
less than 2 MB. *
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Upload

More information

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a
person is not required to respond to a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is 0581- 0287. The
time required to complete this information collection is estimated to average 15 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. The
USDA is an equal opportunity provider and employer.

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